Evidence map›Paper›PMID 39543541›Full record

ArticleBMC cancer2024

Development of a prognostic signature for overall survival using peripheral blood biomarkers in head and neck squamous cell carcinoma treated with immune checkpoint inhibitors.

Cassie Pan, Kevin Ng, Jenna Voutsinas, Brittany Barber, Zain H Rizvi, Emily Marchiano, Rocco M Ferrandino, Neal Futran, George E Laramore, Jay J Liao and 5 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Cassie PanDepartment of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.
Kevin NgClinical Research Division, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA.
Jenna VoutsinasClinical Research Division, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA.
Brittany BarberDepartment of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.
Zain H RizviDepartment of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.
Emily MarchianoDepartment of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.
Rocco M FerrandinoDepartment of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.
Neal FutranDepartment of Otolaryngology-Head and Neck Surgery, University of Washington, Seattle, WA, USA.
George E LaramoreDepartment of Radiation Oncology, University of Washington, Seattle, WA, USA.
Jay J LiaoDepartment of Radiation Oncology, University of Washington, Seattle, WA, USA.
Upendra ParvathaneniDepartment of Radiation Oncology, University of Washington, Seattle, WA, USA.
Neil PanjwaniDepartment of Radiation Oncology, University of Washington, Seattle, WA, USA.
Renato G MartinsDivision of Hematology, Oncology and Palliative Care, Department of Medicine, Virginia Commonwealth University, Richmond, VA, USA.
Cristina P RodriguezDivision of Oncology, Department of Medicine, University of Washington, Seattle, WA, USA.
Qian Vicky WuClinical Research Division, Fred Hutchinson Cancer Center, 1100 Fairview Ave N, Seattle, WA, 98109, USA. qwu@fredhutch.org.

Funding

Research Training in OtolaryngologyT32DC000018 · NIDCD · UNIVERSITY OF WASHINGTON · PI STONE, JENNIFER S. · 1989 to 2023
$7.8M
NIDCD NIH HHS T32 DC000018NIH HHS T32 DC000018
6 · The paper itself

Abstract

backgroundWe previously reported in recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC) treated with immune checkpoint inhibitors (ICIs), pretreatment higher lactate dehydrogenase (LDH) and absolute (abx) neutrophils as well as lower percent (%) lymphocytes correlated with worse overall survival (OS). In this study we aimed to develop a prognostic signature for HNSCC treated with ICIs using these peripheral blood biomarkers (PBBMs).

methodsAdults with R/M HNSCC treated with ICIs at our institution from 08/2012 to 03/2021 with pretreatment PBBMs were included. Follow-up continued until 02/15/2022. The cohort (n = 151) was randomly split into training (n = 100) and testing (n = 51) datasets. A prognostic score incorporating LDH, % lymphocytes, and abx neutrophils was developed from the training dataset using Cox proportional hazards regression. In the training dataset, a grid search identified the optimal cutpoints classifying patients into high, medium, and low-risk groups (trichotomized signature) as well as high vs. low-risk groups (dichotomized signature). The prognostic score, dichotomized and trichotomized signatures were then validated in the testing dataset.

resultsTraining and testing datasets showed no clinically meaningful differences in clinicodemographic characteristics or PBBMs. An OS prognostic model was developed from the training dataset: Risk score = 1.24*log10(LDH) - 1.95*log10(% lymphocytes) + 0.47*log10(abx neutrophils). Optimal risk score cutpoints for the dichotomized and trichotomized signatures were defined in the training dataset, and Kaplan-Meier curves for both dichotomized and trichotomized signatures showed good separation between risk groups. Risk scores were calculated in the testing dataset, where the trichotomized signature demonstrated overlap between low and medium-risk groups but good separation from the high-risk group while the dichotomized signature showed clear separation between low and high-risk groups. Higher risk score correlated with worse OS (HR 2.08, [95%CI 1.17-3.68], p = 0.012). Progression-free survival Kaplan-Meier curves likewise showed excellent separation between dichotomized risk groups in the training and testing datasets.

conclusionsWe developed a prognostic signature for OS based on 3 previously identified PBBMs for HNSCC treated with ICIs and identified a high-risk group of patients least likely to have survival benefit from ICIs. This signature may improve ICI patient selection and warrants validation in an independent cohort as well as correlation with CPS.

Indexed as

Biomarkers, TumorHead and Neck NeoplasmsImmune Checkpoint InhibitorsNeutrophilsSquamous Cell Carcinoma of Head and NeckAdultAgedAged, 80 and overFemaleHumansL-Lactate DehydrogenaseMaleMiddle AgedPrognosisBiomarkers, TumorImmune Checkpoint InhibitorsL-Lactate DehydrogenaseHead and neck cancerImmune checkpoint inhibitorsImmunotherapyPeripheral blood biomarkers

Identifiers

PMID39543541
PMCPMC11566084

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.